Country Focus: Swaziland's Unexpected Success Tackling Paediatric HIV

Khanyisile Mavimbela, Mentor Mother
Khanyisile’s story is all too common in Swaziland, a small landlocked kingdom nestled next to the Lumbombo Mountains and bordered by South Africa and Mozambique. The country’s unfortunate claim to fame is that it has the highest rate of HIV in the world.
One in four adults in Swaziland are reported to be HIV-positive. More women are infected than men and an incredible 41 percent of pregnant women carry the virus.
For a country facing such daunting statistics, Swaziland has made surprising progress in tackling mother-to-child transmission of HIV. It is considered one of the countries that has the potential of reaching the United Nation’s Global Plan goal of eliminating paediatric HIV by 2015. One of the primary reasons is that Swaziland integrated its PMTCT (prevention of mother-to-child transmission) programme into its prenatal care facilities when it was launched in 2003, making HIV testing an essential part of maternal care. There are now PMTCT programmes at 88 percent of the country’s health facilities.
This has contributed to a high proportion of pregnant women being tested for HIV – more than 80 percent by the end of 2010. The number of HIV-positive pregnant women who received antiretroviral drugs (ARVs) to reduce the risk of transmitting the virus to their babies has also grown substantially — from 4 percent in 2004 to an estimated 95 percent in 2011. Widespread use of testing and treatment is starting to have an impact on Swaziland’s paediatric HIV rate. In 2011, 15.4 percent of infants born to HIV-positive mothers were infected with HIV, down 3 percent from 2010.

Tikhuba Support Clinic
It was m2m’s Mentor Mothers who helped Khanyisile come to terms with her diagnosis and disclose her status to her mother. “When I was pregnant, my CD4 count was so low that I had to start treatment there and then. I was worried about being HIV-positive and starting treatment at the same time. It was difficult,” she says. But Khanyisile goes onto to explain how the Mentor Mothers helped her understand the importance of adhering to treatment to stay alive, and keep her baby healthy. “I trusted them. The way they told me their own stories, they created a bond between me and themselves. I wanted to try what they were saying.”
Today, Khanyisile has not one, but two daughters who are HIV-negative, and she is a Site Coordinator for mothers2mothers at the Tikhuba Clinic, located in a rural area of Swaziland near the Mozambican border. Khanyisile says it’s very rare these days that a child is born HIV-positive at her clinic. She says there were only three babies born positive last year, less than half the number in previous years.

Catroina Maovihera, Nurse
mothers2mothers is working with Swaziland’s Ministry of Health to fulfill the goals of the UN Global Plan, and with Site Coordinators like Khanyisile bringing her story of success to the mothers of Swaziland, we are getting closer to making paediatric HIV a thing of the past.